Analysis for heart rate variability in elderly patients with coronary heart disease complicated by hypertension or type 2 diabetes mellitus

doi:10.3969/j.issn.1002-7386.2015.0.001

Abstract：Objective To investigate the heart rate variability ( HRV) in elderly patients with coronary heart disease ( CHD) complicated by hypertension and/or type 2 diabetes mellitus, and to explore the changes of cardiac structure and function and its clinical signioficance.Methods One hundred and forty-three elderly patients with CHD,according to their complications,were divided into four groups:simple CHD group (T0 group, n =31),CHD+hypertension group (T1 group, n=48), CHD+type 2 diabetes mellitus group (T2 group, n =30),CHD+hypertension+type 2 diabetes mellitus group (T3 group, n =34).The HRV indexes,QTc interval, cardiac structure and function were observed and compared among the four groups to evaluate the changes of cardiac autonomic nerve,cardiac structure and function.Results SDNN,SDANN index, SDNN index,rMSSD, PNN50 and HRV triangular index in T3 group were significantly lower than those in the other three groups ( P <0.05).In T3 group they were significantly increased,as compared with those in the other three groups ( P <0.05).The SDNN,SDNN index, rMSSD,HRV triangular index in T1 group and T2 group were significantly decreased,as compared with those in T0 group ( P <0.05).SDANN index in T1 and T3 group was significantly lower than that in T0 group,however, QTc interval in T1 group was obviously longer than that in T3 group ( P <0.05).LVEF in T3 group was significantly lower than that in T0,T1,T2 groups ( P <0.05),however,LVEDV and LVESV in T3 group were obviously increased,as compared with those in T0,T1,T2 groups ( P <0.05) .E/A in T3 group was significantly lower than that in T0 group ( P <0.05),but LA in T3 group was obviously increased ( P <0.05).SDNN was negatively correlated to LA, LVEDV,LVESV,however,which was positively correlated to LVEF and E/A ( P <0.05).The rMSSD was positively related with LVEF and E/A ( P <0.05) .HRV triangular index was negatively correlated to LVEDV,however, which was positively related with LVEF ( P <0.05) .QTc interval was positively related with LVEDV and LVESV,however,which was negatively correlated to LVEF ( P <0.05).Conclusion The heart autonomic nervous function and cardiac structure in elderly patients with coronary heart disease complicated by hypertension and type 2 diabetes mellitus are severely damaged,however, HRV can reflect the the severity of heart structure remodeling and the damage degree of heart function.